Basic Information
| Provider Information | |||||||||
| NPI: | 1740437714 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STILZ | ||||||||
| FirstName: | KATHRYN | ||||||||
| MiddleName: | R. | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3174 CUSTER DR | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405174000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592734882 | ||||||||
| FaxNumber: | 8592737758 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 TRADE ST | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405112634 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8594558431 | ||||||||
| FaxNumber: | 8594558431 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2008 | ||||||||
| LastUpdateDate: | 08/21/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 004658 | KY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.